Grum, Kim Marie
Grum, Kim Marie is an sole proprietor health care provider with primary practice located at 2512 Golden Sands Dr , Las Vegas NV 89128-6801. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Grum, Kim Marie can be contacted via phone (215) 919-1558.Contact Information
Primary practice address
2512 Golden Sands Dr
Las Vegas NV 89128-6801
Phone: (215) 919-1558
Fax: (215) 491-1750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 13939693 | Utah |
Profile Details
| NPI number | 1649271933 |
|---|---|
| LBN Legal business name | Grum, Kim Marie |
| Credentials | LSUDC, CAADC, CRS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2005 |
| Last updated | May 20th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649271933 | NPPES |
| Pennsylvania | Other | 0284366000 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | MEDICAID | 07802520 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | MEDICAID | 1649271933 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | Other | 447982 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | Other | 1015164 | INDEPENDENCE BLUE CROSS |
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